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A hospital lipid-lowering protocol improves 2-year clinical outcomes in patients with acute coronary syndrome

Sho Nakao1, Takayuki Ishihara, Takuya Tsujimura

  • 1Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Japan.

Asiaintervention
|September 30, 2024
PubMed

Insights

A hospital lipid-lowering protocol (HLP) significantly reduced non-target vessel revascularisation (non-TVR) in acute coronary syndrome (ACS) patients. This effective strategy improves long-term clinical outcomes after ACS treatment.

Area of Science:

  • Cardiology
  • Clinical Research
  • Pharmacotherapy

Background:

  • Despite advancements, patients with acute coronary syndrome (ACS) face persistent risks of cardiovascular events in the chronic phase.
  • A structured hospital lipid-lowering protocol (HLP) may optimize long-term management and clinical outcomes post-ACS.

Purpose of the Study:

  • To evaluate the impact of implementing a hospital lipid-lowering protocol (HLP) on clinical outcomes in patients following acute coronary syndrome (ACS).

Main Methods:

  • Retrospective analysis of 1,114 ACS patients post-percutaneous coronary intervention (2011-2021).
  • Introduction of HLP in December 2018, involving maximum tolerated statin, ezetimibe, and eicosapentaenoic acid.
  • Comparison of 2-year non-target vessel revascularisation (non-TVR) rates between pre-HLP (control) and post-HLP groups.
  • Statistical analysis using multivariable Cox proportional hazard models and inverse probability weighting (IPW).

Main Results:

  • The HLP group demonstrated a significantly lower cumulative 2-year non-TVR incidence (8.5%) compared to the control group (13.8%; p=0.019).
  • Multivariable analysis indicated a significantly reduced risk of non-TVR in the HLP group (aHR: 0.637; p=0.038).
  • IPW analysis confirmed the association between HLP and lower non-TVR risk (aHR: 0.544; p=0.007).

Conclusions:

  • Implementation of a hospital lipid-lowering protocol (HLP) is associated with improved 2-year clinical outcomes for patients after acute coronary syndrome (ACS).
Abstract

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